Anal Warts: Symptoms, Treatment, and Recovery Insights

Anal warts

Hello, Doctor.
A year ago, I had two sessions of electrocautery treatment, but it was really painful, so I switched to using wart removal cream.
I applied it occasionally, and sometimes it just looked like it was there, so I endured the pain to apply the medication.
The last time I applied the cream was around mid-June, and I wasn't very sure if it was genital warts because it looked somewhat similar, so I decided to apply it anyway.
I check for recurrence every day while showering, and every couple of weeks, I try to inspect with a mirror.

Today, I noticed something concerning.
When I looked with a mirror, I saw that the area from the anus (which looks more like skin color) to the rectum (which is a reddish flesh color) has some small pinkish lumps.
I remember that the previous warts were located in the small area between the anus and the reddish flesh of the rectum.
I want to ask the doctor if warts can grow into the rectum, which is the reddish area.
I noticed that the small lumps near the reddish area of the anus are slightly pink and resemble small flesh balls, but they look different from the warts I previously saw inside the anus.
Those small lumps are closer to a smooth surface, while the warts I saw before had a rough or spiky texture.

Is it possible that the scab tissue from the previous electrocautery treatment has gradually changed into this? I haven't found anyone asking about what the wound looks like after electrocautery inside the anus; most discussions are about how to care for the wound after the procedure.
The small lumps are not hard and have a smooth surface, while the warts I previously felt were harder than these small lumps.
However, they are a different color from the surrounding tissue, so I’ve been unsure if they are warts.
They are slightly raised, maybe two or three small areas.

I appreciate your help in clarifying this.
After such a long treatment, I’ve developed the ability to relax and use a flashlight to inspect my anus thoroughly...
(finding humor in the situation).
I hope I can get treated quickly and forget about this ability.
Thank you, Doctor.

e, 20~29 year old female. Ask Date: 2018/07/27

Dr. Ke Fangxu reply Surgery

Indeed, cauliflower lesions can potentially invade the lower rectum, but whether it is actually cauliflower or scar tissue from electrosurgery can only be determined through a medical examination.
Sometimes, if it is difficult to make a judgment, it is recommended to stop medication and observe for a month.
If the lesion continues to grow, it should be treated as cauliflower.
If there is no change or if it shrinks, it is likely scar tissue from the electrosurgery.

Reply Date: 2018/07/27

More Info

Anal warts, also known as anal condylomas, are caused by the human papillomavirus (HPV) and can manifest as small growths around the anal area. They can be quite distressing, both physically and emotionally, and your concerns about their appearance and potential recurrence are completely valid.
From your description, it seems you have undergone treatment for anal warts through electrosurgery, which is a common method for removing these growths. The fact that you have noticed changes in the texture and appearance of the area post-treatment raises some important considerations.

1. Understanding the Appearance of Anal Warts: Anal warts typically appear as small, fleshy growths that can be rough or smooth in texture. The smooth, pinkish bumps you are observing may not necessarily be warts but could be a result of healing tissue or scarring from the electrosurgery. It is not uncommon for the skin to change in appearance after such procedures, and the healing process can sometimes lead to the formation of new tissue that may look different from the original warts.

2. Can Warts Grow Inside the Rectum?: While anal warts primarily occur on the external anal area, HPV can affect the internal anal canal and rectum as well. It is possible for warts to develop in these areas, although they are less commonly diagnosed. The presence of smooth, pinkish bumps near the rectum could be indicative of either new growths or healing tissue from previous treatments.
3. Differentiating Between Warts and Healing Tissue: The key difference you noted between the previous warts and the new bumps is their texture. Warts typically have a rough surface, while healing tissue may appear smoother. If the bumps are soft and not hard, they could be a result of the healing process. However, it is essential to have these changes evaluated by a healthcare professional to rule out any recurrence of warts or other conditions.

4. Follow-Up Care: Given your history of treatment and the current changes you are observing, it is advisable to schedule a follow-up appointment with your healthcare provider. They can perform a thorough examination, possibly including a visual inspection and, if necessary, a biopsy to determine the nature of the new growths. This will help ensure that any potential recurrence of warts is addressed promptly.

5. Psychological Impact: It’s understandable that dealing with anal warts can be emotionally taxing. The anxiety surrounding their appearance and the fear of recurrence can lead to significant stress. It might be beneficial to discuss these feelings with a healthcare provider or a mental health professional who can offer support and coping strategies.

6. Preventive Measures: To reduce the risk of recurrence, consider discussing HPV vaccination with your healthcare provider. The vaccine can protect against the strains of HPV that most commonly cause anal warts and other HPV-related diseases.

In conclusion, while the changes you are observing may be related to the healing process post-treatment, it is crucial to have them evaluated by a healthcare professional. They can provide clarity on whether these are new warts or simply healing tissue and recommend appropriate treatment options if necessary. Remember, you are not alone in this journey, and seeking help is a positive step toward recovery.

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